Dr. Christine Hemphill-Jones   

“My background is that I trained at the Medical University of South Carolina for medical school. I originally went to become a radiologist and learned that I loved being in the operating room. My first experiences in the OR were with GYN Oncology, some of the ugliest of the ugly when it comes to stuck pelvises, but with careful and meticulous dissection, anatomy was usually pretty clear. I changed direction and decided to pursue OBGYN training, but was mostly interested in infertility. My faith does not allow me to support IVF, so I wanted to learn what I could treat as a generalist OBGYN. I was a resident at East Carolina University, which had a very strong minimally invasive surgery program. As a chief OBGYN, I attended a 2 day course in FL taught by Dr. McCarus, who pulled me aside and asked me why I was there… he said I had better skills than his fellows and was wasting my time at the course.

I had already been introduced to NaProTECHNOLOGY and decided to pursue that fellowship training after residency, so I went to Omaha, Nebraska and trained under Dr. Thomas Hilgers. Dr. Hilgers ascribed to Dr. Redwine’s near-contact laparoscopic technique and emphasized the importance of being able to surgically identify the various appearances of endometriosis. It was from Dr. Hilgers that I learned the best surgical technique for endometriosis was excision, with laser vaporization occasionally being utilized, but never electrocautery (fulguration/ablation). I trained under him when laparoscopy was used for diagnostics and laparotomy was primarily used for therapeutic surgery if there was a moderate or severe disease load (basically anything more than stage 1). However, this was also the time when he began incorporating robotics, in which I was already proficient from my residency training. I had over 400 surgical cases in my 1 year of training, many of which were advanced staged endometriosis and often involved the bowels. Although we had general surgeons available to aid us, many of the bowel-involving cases which did not need a bowel resection were managed by us, so I feel quite comfortable with resecting lesions involving the bowel myself. Additionally, we did a good bit of ureterolysis ourselves.

My personal approach is that endometriosis is primarily a surgical disease.

I do not generally treat with hormonal suppression. There have been a small handful of cases where after surgical resection, which often included hysterectomy when appropriate, I have treated with leuprolide after patients have requested to pursue this therapy. My preference to to avoid hysterectomy, if possible and to preserve ovaries, when appropriate. However, I will offer a total hysterectomy and bilateral salpingo-oophorectomy, if disease is suspected in those areas and the patient can appreciate the risks of those procedures, including the cardiovascular and bone health risks following bilateral oophorectomy. I will discuss the pros and cons of HRT if surgical menopause also results in hormonal menopause and if the patient wishes to pursue HRT, I will offer it.

I do not prescribe contraceptives. I prefer to recommend alternative approaches to medical therapies for endometriosis, dysmenorrhea, and dyspareunia. I will encourage diet modifications for anti-inflammatory diets like Paleo, Whole30, Autoimmune Protocol (gluten-free, dairy-free). I also advocate for antioxidant regimens (Vitamin E, Vitamin D, Vitamin C, Pycnogenol, N-Acetylcysteine). If a patient is interested in trialing low dose naltrexone, I will support that.

Multi-disciplinary approach: I counsel that pelvic floor physical therapy can be a good adjunct to what I can offer. If pain is persistent, I will manage with NSAIDs, neuromodulators such as pregabalin and gabapentin, psychiatric meds like duloxetine and amitriptyline and, if needed, I will occasionally manage long term narcotic use with pain contracts. It is my preference to involve a pain management specialist when able. They often can offer more than I can with blocks, pumps, and other things, like ketamine infusion, when appropriate. If psychologists/psychiatrists seem appropriate, I will encourage/offer referrals.

I do not feel that a woman is ‘not my problem’ once hysterectomy and oophorectomy has been performed. I do not routinely recommend colonoscopies since it is rare that endometriosis is fully invading through the bowel. However, if a patient disclosed bloody stool, then I feel this should be evaluated as it may adjust my approach and lead me to proactively involve a general surgeon for resection.

As far as imaging, I more frequently utilize ultrasound. There are indicators of advanced disease if there is no evidence of bowel sliding. Adenomyosis can also be appreciated on ultrasound, but if that is not noted and symptoms are still suspicious, I may recommend MRI. Additionally, if symptoms are atypical, I may also seek MRI assessment as I know it can be involved in the rectus sheath/fascia, especially if history of abdominal surgery.

I have treated diaphragmatic endometriosis, bowel endometriosis (small and large), appendiceal endometriosis, bladder endometriosis, para-ureteral endometriosis, umbilical endometriosis, and abdominal wall endometriosis. Because of my NaPro training, I often have patients travel from out of state, so I am accustomed to helping patients who are not local.”

Dr. Hemphill-Jones is a parishioner of Our Lady of Perpetual Help Catholic Church.  She has 5 children with her late husband, Jason Hemphill, 1 child with her current husband, Phillip Jones, and 3 step-children.  She has been practicing since 2012 with her primary focus of treating infertility, endometriosis, and polycystic ovarian syndrome via NaProTECHNOLOGY, an advanced form of reproductive surgery.  She enjoys cooking for her family and creating charcuterie boards for get-together with friends.

Dr. Hemphill-Jones operates at Methodist McKinney Hospital in McKinney, Texas.

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